Dolly’s Greatest Healthcare Hits

I have a confession: I’m terrible at picking favorites.

Apparently, my son inherited that trait. Ask him what he wants for dinner, which shirt he likes or what movie he wants to watch, and a simple choice becomes a major production.

So when I was asked to name my favorite Dolly Parton song, I had a problem. How do you pick one from hundreds?

Then came the real challenge: Can Dolly Parton’s songs teach us anything about healthcare?

Not literally. Her songs aren’t about formularies, insurance networks or medical bills. But listen a little differently, and suddenly, Dolly has a healthcare playlist.

So, in true Dolly fashion, let’s put on a few different hats and take a listen.

“Islands in the Stream”
Healthcare can sometimes feel like a collection of islands.

There’s your primary care doctor. Then a specialist. A hospital. A pharmacy. An insurer. A lab.

They may all be doing important work, but too often, the patient is the one stuck swimming between them.

Fragmented care isn’t just frustrating. When information doesn’t follow the patient or healthcare providers don’t communicate, things can fall through the cracks.

The goal shouldn’t just be better islands.

We need better bridges.

“Jolene”
In Dolly’s famous song Jolene, the message is essentially: Please don’t take what’s important to me.

That sounds pretty familiar in today. Don’t take away the coverage that makes a medication affordable. Don’t take away access to a doctor. Don’t make coverage so expensive that people can’t afford to use it.

Changes to federal healthcare subsidies, Medicaid and other coverage healthcare insurance programs aren’t simply policy debates. They can affect whether someone fills a prescription, sees a specialist or puts off care.

Maybe the healthcare version of “Jolene” is just this simple: Please don’t take my coverage away.

“Here You Come Again”
And then there are the medical bills.

Here you come again.

Just when you think you’ve dealt with one medical bill, another arrives.

Then comes the explanation of benefits.

Then another statement.

Then the phone call to figure out why the amount doesn’t look anything like what you expected.

And the surprises don’t stop there.

Oops — your medication isn’t on the formulary.

Oops again — your doctor isn’t in the network.

And another oops — the test your doctor ordered isn’t covered.

Just when you think you’ve figured out healthcare, another surprise appears.

“Coat of Many Colors”
And perhaps one of Dolly’s most personal songs gives us the biggest healthcare lesson.

Her mother made Dolly a coat from rags because that was all the family had. The children at school laughed at her. They saw scraps.

Dolly saw something else: Love. Warmth. Value.

They judged the coat by what it looked like. Dolly knew what it could do.

Healthcare can be judged the same way. We see premiums, deductibles, copays and bills. We see the cost.

But we don’t always see what we’re buying: protection against the unexpected. And some of healthcare’s greatest value is even harder to see.

A vaccine prevents an illness we never get. A screening catches cancer before it becomes a crisis. A medication helps prevent a heart attack or keeps someone healthy enough to work.

When prevention works, nothing happens. And that’s the point.

That’s the tricky thing about protection: you don’t appreciate the coat until the weather changes.

Maybe that’s the lesson hidden in Dolly’s coat.

So, do I have a favorite Dolly Parton song?

Nope. Apparently, I still can’t pick.

But when it comes to healthcare, I’m starting to think Coat of Many Colors might be a pretty good place to start!

Happy reading,
Suzanne Daniels, Ph.D.